老年肺癌患者肺叶切除术后深静脉血栓发生情况及影响因素分析  

Occurrence and influencing factors of deep venous thromboembolism after lobectomy in elderly patients with lung cancer

作　　者：张怡[1] 刘叶 王芳[2] 贾琎蕊 宋盛晗[3] Zhang Yi;Liu Ye;Wang Fang;Jia Jinrui;Song Shenghan(Department of Thoracic Surgery,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China;Department of Respiratory and Critical Care Medicine,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China;Department of Vascular Surgery,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院胸外科,北京100020 [2]首都医科大学附属北京朝阳医院呼吸与危重症医学科,北京100020 [3]首都医科大学附属北京朝阳医院血管外科,北京100020

出　　处：《血管与腔内血管外科杂志》2025年第1期31-34,45,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的 探讨老年肺癌患者肺叶切除术后深静脉血栓(DVT)的发生情况及影响因素。方法 收集2021年5月至2024年2月于首都医科大学附属北京朝阳医院实施肺叶切除术治疗的106例老年肺癌患者的临床资料,根据术后是否发生DVT将患者分为DVT组(n=21)和对照组(n=85)。收集两组患者的基本资料、病史、生化指标、围手术期指标、治疗及用药情况等进行单因素分析,将单因素分析中差异有统计学意义的因素纳入多因素Logistic回归模型,分析老年肺癌患者肺叶切除术后发生DVT的危险因素。结果 单因素分析结果显示,两组患者的年龄、体重指数、高血压比例、糖尿病比例、术前血小板计数、术后D-二聚体水平、手术时间、术后卧床时间比较,差异均有统计学意义(P<0.05)。多因素分析结果显示,高血压、糖尿病、术前血小板计数、术后D-二聚体水平均为老年肺癌患者肺叶切除术后发生DVT的独立危险因素(P<0.05)。结论 高血压、糖尿病、术前血小板计数、术后D-二聚体水平均会影响老年肺癌患者肺叶切除术后发生DVT的风险,临床需在术前对于存在以上指标的高危患者采取强化管理。Objective To investigate the occurrence and influencing factors of deep vein thromboembolism(DVT)in elderly patients with lung cancer after lobectomy.Method The clinical data of 106 elderly lung cancer patients who underwent lobectomy in Beijing Chao-Yang Hospital,Capital Medical University from May 2021 to February 2024 were collected.The patients were divided into DVT group(n=21)and control group(n=85)based on whether DVT occurred after surgery.The basic data,medical history,biochemical indexes,perioperative indexes and treatment and medication conditions in the two groups were collected for univariate comparative analysis.The factors with statistical differences in univariate analysis were included in multivariate Logistic regression model to analyze the influencing factors of DVT after lobectomy in elderly patients with lung cancer.Result The results of single factor analysis indicated that there were statistically significant differences between the two groups in terms of age,body mass index,hypertension,diabetes mellitus,preoperative platelet count,postoperative D-dimer level,surgical time and postoperative bed rest time(P<0.05).Multivariate analysis indicated that hypertension,diabetes mellitus,preoperative platelet count and postoperative D-dimer level were risk factors for DVT in elderly lung cancer patients after lobectomy(P<0.05).Conclusion Hypertension,diabetes mellitus,preoperative platelet count and postoperative D-dimer all affect the risk of DVT after lobectomy in elderly patients with lung cancer.It is necessary to adopt intensive management of high-risk patients with the above indicators before surgery.

关 键 词：老年 肺癌 肺叶切除术 深静脉血栓 影响因素 

分 类 号：R543[医药卫生—心血管疾病]